Project 459004

Canada is experiencing a prolonged and worsening overdose epidemic. The provision of a safe and regulated supply of pharmaceutical-grade drugs is a necessary response to a growing national public health crisis. A number of novel prescribed safe supply programs have recently been initiated, the majority of which are operating in BC and Ontario. However, the rollout of prescribed safe supply is highlighting the limitations of prescriber-led programs. People who use drugs caution that controlled dispensing models risk overburdening clients, and clinicians have raised concerns about the appropriateness of having prescribers deliver a public health intervention. There is a need for greater diversity of safe supply programs and dispensing models. Despite significant investment in the medical model, no research has been conducted on the fit of primary care, or of other potential dispensing models, to deliver safe supply. This study responds by conducting research with policy and practice implications on the limitations and strengths of the current medical model and of potential alternate dispensing models in BC and Ontario. Using the Consolidated Framework for Implementation Research, it seeks to identify policy, clinical, regulatory, social-structural, and systems-level factors that facilitate and hinder the uptake, implementation, and delivery of safe supply. Findings will inform model innovation and enhance relevance, usability, and sustainability in existing programs and be of special interest to Canadian governments and jurisdictions considering safe supply.